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everetl <br />e� <br />City of Everett <br />� <br />� <br />��� <br />= <br />� - r t O P <br />W �"1 <br />.-� +P M <br />Sewer Application and Perr�it% � <br />z <br />`_ i���� <br />26922 _� � � � <br />NO. DATE Novoub� 2,. 1—_a_+e <br />Service Address 709 �• H='O��°y Utility Account <br />Billing Address �M <br />City, State, Zip �=att, if11 96201 <br />Owner (Mortgayor) a+ehlntou State DOT _ <br />Billing Name �� <br />Connection By �� <br />Address S+� <br />Phcne 764—�279 <br />DESCRIPTION: <br />Lot <br />Plat <br />CHART <br />S�T'Cn F�7NS <br />a.�.� <br />Permit Fee lo_no <br />Connection Charge�s) <br />Tota! <br />i "" .__ _ <br />, f` ; ., <br />{ i <br />Signed � �\�:� � /� — <br />! / <br />� Custo�rfer ' <br />Sewer D <br />Monthly Sewer <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit: <br />Remarks: <br />, � �� <br />/ / �� J <br />—v h <br />\c, � � <br />V,,u <br />IMPORTANT! <br />CALL 1500 4.2A-5555 48•HOURS <br />PRIOP TO DIGGING <br />CALL 259-8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Tru <br />Abutting L�t Line <br />�;,S,E,W. <br />Approved By �or., A, g7y��, <br />City E�g��eer <br />Issued By ^uay B�ugoa <br />Inspection <br />Datelnspected <br />NO. 26922 <br />I i�SPECTION <br />